Healthcare website missteps revealed

White House chief technology officer Todd Park testifies before the House Oversight Committee about problems with implementation of the Obamacare healthcare program, and specifically, the HealthCare.gov website, on Capitol Hill in Washington, Wednesday, Nov. 13, 2013. At left is Frank Baitman, deputy assistant secretary for information technology at the Department of Health and Human Services. (AP Photo/J. Scott Applewhite)
(Photo: J. Scott Applewhite)

At 9 a.m. on Aug. 22, a team of federal health officials sat down in a Baltimore conference room with at least a dozen employees of CGI Federal, the company with the main contract to build the online federal health insurance marketplace. For six weeks, the federal officials overseeing the project had become increasingly worried that CGI was missing deadlines, understaffing the work and overstating its progress.

As the meeting began, one of the officials reminded the CGI employees that HealthCare.gov was “the president’s number one priority,” assured them that the discussion would be a “blame-free zone,” and then bored in. “We must be honest and open with each other,” the official said, according to documents obtained from participants in the session. “I have to know what I don’t know.”

Need to ‘build trust’

The top CGI executive in the room sounded contrite. “We recognize we have to build trust back,” said Cheryl Campbell, the company’s senior vice president in charge of the project.

For that day and the next, CGI staff huddled with government officials in the conference room at the headquarters of the federal Centers for Medicare and Medicaid Services, the agency overseeing the project. They combed through 15 pages of spreadsheets they had brought, which spelled out the company’s level of confidence — high, medium or low — that individual components would be ready.

By the time HealthCare.gov launched 5
½ weeks later, many of those predictions proved wrong, according to internal documents obtained by The Washington Post and officials familiar with the project.

A final “pre-flight checklist” before the website’s Oct. 1 opening, compiled a week before by the Centers for Medicare and Medicaid Services, shows that 41 of 91 separate functions that CGI was responsible for finishing by the launch were still not working.

And a spreadsheet produced by CGI, dated the day of the launch, shows that the company acknowledged about 30 defects on features scheduled to have been working already, including five that it classified as “critical.” For instance, one critical defect was that people who had finished creating applications — an early step in enrolling — got incorrect messages that their applications were incomplete if they tried to sign back in.

All told, of the 45 items in which CGI had expressed high confidence at the late August meeting in Baltimore, most were still not ready by the time consumers were supposed to be able to start to buy health plans online through the federal marketplace, according to a government official familiar with the project who spoke on the condition of anonymity to discuss private information.

On time; fouled up

During those crucial final weeks before the marketplace opened, the official said, CGI often delivered components on time, but they contained such faulty computer code that features did not hold up under closer scrutiny — or failed later if more than several thousand people at a time tried to use them. These included essential but arcane parts of the website, as well as facets that have attracted substantial public and congressional attention, such as a feature — still not working — that was supposed to let insurance-seekers browse the health plans available to them without first registering for an online account.

Asked to discuss its performance, a CGI spokeswoman referred to a statement the company’s president and chief executive, Michael Roach, made during an “earnings call” earlier this month: “As is our practice, we honor our confidentiality agreements with customers and, accordingly, we do not discuss individual contracts on analyst calls or any public forum.”

The statement said that the company is “continuing to work in close partnership” with the Centers for Medicare and Medicaid Services and another IT company, QSSI, which the Obama administration last month put in charge of overseeing fixes to the website. “Our partnership is collaborative, and we are focused on an successful outcome.”

In the eight weeks since the opening of the federal insurance exchange — a launch that White House officials have acknowledged was “disastrous” — government employees and contractors, including CGI, have been scrambling to fix the site. Health officials have emphasized pieces of progress — including doubling the number of people who can use it at once before it malfunctions — but there is no known tally of the percentage of flaws that have been corrected.

During the past two months, it has become evident that no single reason explains why HealthCare.gov, a top administration priority, was not ready 3
½ years after President Barack Obama signed a sprawling law designed to reshape the U.S. health care system. Work to build the online marketplace was hindered, in part, by White House micromanagement and political sensitivities that delayed policy and regulatory decisions, fierce Republican opposition to the law, and the fact that no one at the Centers for Medicare and Medicaid Services or elsewhere at Department of Health and Human Services, of which the agency is a part, had the job of managing the project full time.

CGI central player

But the documents and interviews make clear that CGI, by far the most central of about four dozen companies with contracts to help build the exchange, made repeated missteps. The government’s contract with CGI was $197 million as of August.

A spokeswoman for the Centers for Medicare and Medicaid Services said that the agency had engaged in “hundreds of operationally focused planning conversations” to prepare for the launch of online enrollment on Oct. 1. The spokeswoman, Patti Unruh, said that the agency postponed some aspects of the project when it became clear that not all of the system could be ready on time.

The Obama administration has set a deadline of next Saturday by which officials have promised that HealthCare.gov will work smoothly for about four out of five consumers who attempt to use it to sign up for health plans. Even now, the official familiar with the project said, CGI’s work on the repairs is not always going well; roughly one-third to half the new computer code the company is writing cannot be used because it is revealing flaws when it is fully examined by a group of outside testers, including some insurance companies.

HealthCare.gov was intended to be the main method used by a group of consumers in 36 states to get health insurance. The federal exchange, and similar ones just opened by Kentucky and 13 other states, are designed to provide health plans to people who can’t get affordable insurance through their jobs or for small businesses. The coverage is to become available starting Jan. 1.